Psychological Distress after inpatient non-cardiac Surgery

Author:

Gandotra Sakshi12,Daza Julian F.34,Diep Calvin13,Mitani Aya A.5,Ladha Karim S.123,Wijeysundera Duminda N.123,

Affiliation:

1. Department of Anesthesiology and Pain Medicine, University of Toronto

2. Department of Anesthesia, St. Michael’s Hospital, Toronto

3. Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto

4. Division of General Surgery, Department of Surgery, University of Toronto

5. Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto

Abstract

Objective: Describe the incidence and natural progression of psychological distress after major surgery. Summary Background: The recovery process following surgery imposes physical and mental burdens that put patients at risk of psychological distress. Understanding the natural course of psychological distress after surgery is critical to supporting timely and tailored management of high-risk individuals. Methods: We conducted a secondary analysis of the Measurement of Exercise Tolerance before Surgery (METS) multicentre cohort study (Canada, Australia, New Zealand, UK). METS recruited adult participants (≥40 y) undergoing elective inpatient non-cardiac surgery and followed them for one year. The primary outcome was the severity of psychological distress measured using the anxiety-depression item of EQ-5D-3L. We used cumulative link mixed models to characterize the time trajectory of psychological distress among relevant patient subgroups. We also explored potential predictors of severe and/or worsened psychological distress at one year using multivariable logistic regression models. Results: Of 1,546 participants, moderate-to-severe psychological distress was reported by 32.6% of participants before surgery, 27.3% at 30 days after surgery, and 26.2% at 1 year after surgery. Psychological distress appeared to improve over time among females (OR 0.80, 95% CI 0.65–0.95) and patients undergoing orthopedic procedures (OR 0.73, 95% CI 0.55–0.91), but not among males (OR 0.87, 95% CI 0.87–1.07) or patients undergoing non-orthopedic procedures (0.95, 95% CI 0.87–1.04). Among the average middle-aged adult, there were no time-related changes (OR 0.94, 97% CI 0.75–1.13) whereas the young-old (OR 0.89, 95% CI 0.79–0.99) and middle-old (OR 0.87, 95% CI 0.73–1.01) had small improvements. Predictors of severe and/or worsened psychological distress at one year were younger age, poor self-reported functional capacity, smoking history, and undergoing open surgery. Conclusion: One-third of adults experience moderate to severe psychological distress before major elective non-cardiac surgery. This distress tends to persist or worsen over time among select patient subgroups.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Surgery

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3